LidPose: Real-Time 3D Human Pose Estimation in Sparse Lidar Point Clouds with Non-Repetitive Circular Scanning Pattern.

In this paper, we propose a novel, vision-transformer-based end-to-end pose estimation method, LidPose, for real-time human skeleton estimation in non-repetitive circular scanning (NRCS) lidar point clouds. Building on the ViTPose architecture, we introduce novel adaptations to address the unique properties of NRCS lidars, namely, the sparsity and unusual rosetta-like scanning pattern. The proposed method addresses a common issue of NRCS lidar-based perception, namely, the sparsity of the measurement, which needs balancing between the spatial and temporal resolution of the recorded data for efficient analysis of various phenomena. LidPose utilizes foreground and background segmentation techniques for the NRCS lidar sensor to select a region of interest (RoI), making LidPose a complete end-to-end approach to moving pedestrian detection and skeleton fitting from raw NRCS lidar measurement sequences captured by a static sensor for surveillance scenarios. To evaluate the method, we have created a novel, real-world, multi-modal dataset, containing camera images and lidar point clouds from a Livox Avia sensor, with annotated 2D and 3D human skeleton ground truth.

Climate-Water Adaptation for Future US Electricity Infrastructure.

Future climate-water conditions are anticipated to increase electricity demand, reduce transmission capacity, and limit power production. Yet, typical electricity capacity expansion planning does not consider climate-water constraints. We project four alternative U.S. power system configurations using an iterative modeling and data exchange platform that integrates climate-driven hydrological, thermal power plant, and capacity expansion models. Through a comparison with traditional modeling approaches, we show that this novel approach provides greater confidence in electricity capacity projections by incorporating feasibility checks that adjust infrastructure development to reach grid reliability thresholds under climate-water constraints. Initial projections without climate-water impacts on electricity generation show future power systems become less vulnerable, independent of climate-water adaptation, as economic drivers increase renewable and natural gas-based capacity, while water-intensive coal and nuclear plants retire. However, power systems may face reliability challenges without climate-water adaptation, revealing the significance of incorporating climate-water impacts into power system planning. Climate-adjusted (Iterative approach) projections require a 5.3-12.0% increase in national-level capacity, relative to Initial projections, leading to an additional $125-143 billion (5.0-7.0%) in infrastructure costs. Variable renewable and natural gas technologies account for nearly all the additional capacity and, together with regional trade-offs in electricity generation, enhance grid performance to reach reliability thresholds. These adaptation transitions also lower water use and emissions, contributing to climate change mitigation, and highlight the trade-offs and impacts of both near and long-term electricity generation planning decisions.

Hydrological droughts in the 21st century, hotspots and uncertainties from a global multimodel ensemble experiment.

Increasing concentrations of greenhouse gases in the atmosphere are expected to modify the global water cycle with significant consequences for terrestrial hydrology. We assess the impact of climate change on hydrological droughts in a multimodel experiment including seven global impact models (GIMs) driven by bias-corrected climate from five global climate models under four representative concentration pathways (RCPs). Drought severity is defined as the fraction of land under drought conditions. Results show a likely increase in the global severity of hydrological drought at the end of the 21st century, with systematically greater increases for RCPs describing stronger radiative forcings. Under RCP8.5, droughts exceeding 40% of analyzed land area are projected by nearly half of the simulations. This increase in drought severity has a strong signal-to-noise ratio at the global scale, and Southern Europe, the Middle East, the Southeast United States, Chile, and South West Australia are identified as possible hotspots for future water security issues. The uncertainty due to GIMs is greater than that from global climate models, particularly if including a GIM that accounts for the dynamic response of plants to CO2 and climate, as this model simulates little or no increase in drought frequency. Our study demonstrates that different representations of terrestrial water-cycle processes in GIMs are responsible for a much larger uncertainty in the response of hydrological drought to climate change than previously thought. When assessing the impact of climate change on hydrology, it is therefore critical to consider a diverse range of GIMs to better capture the uncertainty.

First look at changes in flood hazard in the Inter-Sectoral Impact Model Intercomparison Project ensemble.

Climate change due to anthropogenic greenhouse gas emissions is expected to increase the frequency and intensity of precipitation events, which is likely to affect the probability of flooding into the future. In this paper we use river flow simulations from nine global hydrology and land surface models to explore uncertainties in the potential impacts of climate change on flood hazard at global scale. As an indicator of flood hazard we looked at changes in the 30-y return level of 5-d average peak flows under representative concentration pathway RCP8.5 at the end of this century. Not everywhere does climate change result in an increase in flood hazard: decreases in the magnitude and frequency of the 30-y return level of river flow occur at roughly one-third (20-45%) of the global land grid points, particularly in areas where the hydrograph is dominated by the snowmelt flood peak in spring. In most model experiments, however, an increase in flooding frequency was found in more than half of the grid points. The current 30-y flood peak is projected to occur in more than 1 in 5 y across 5-30% of land grid points. The large-scale patterns of change are remarkably consistent among impact models and even the driving climate models, but at local scale and in individual river basins there can be disagreement even on the sign of change, indicating large modeling uncertainty which needs to be taken into account in local adaptation studies.

Constraints and potentials of future irrigation water availability on agricultural production under climate change.

We compare ensembles of water supply and demand projections from 10 global hydrological models and six global gridded crop models. These are produced as part of the Inter-Sectoral Impacts Model Intercomparison Project, with coordination from the Agricultural Model Intercomparison and Improvement Project, and driven by outputs of general circulation models run under representative concentration pathway 8.5 as part of the Fifth Coupled Model Intercomparison Project. Models project that direct climate impacts to maize, soybean, wheat, and rice involve losses of 400-1,400 Pcal (8-24% of present-day total) when CO2 fertilization effects are accounted for or 1,400-2,600 Pcal (24-43%) otherwise. Freshwater limitations in some irrigated regions (western United States; China; and West, South, and Central Asia) could necessitate the reversion of 20-60 Mha of cropland from irrigated to rainfed management by end-of-century, and a further loss of 600-2,900 Pcal of food production. In other regions (northern/eastern United States, parts of South America, much of Europe, and South East Asia) surplus water supply could in principle support a net increase in irrigation, although substantial investments in irrigation infrastructure would be required.

Multimodel assessment of water scarcity under climate change.

Water scarcity severely impairs food security and economic prosperity in many countries today. Expected future population changes will, in many countries as well as globally, increase the pressure on available water resources. On the supply side, renewable water resources will be affected by projected changes in precipitation patterns, temperature, and other climate variables. Here we use a large ensemble of global hydrological models (GHMs) forced by five global climate models and the latest greenhouse-gas concentration scenarios (Representative Concentration Pathways) to synthesize the current knowledge about climate change impacts on water resources. We show that climate change is likely to exacerbate regional and global water scarcity considerably. In particular, the ensemble average projects that a global warming of 2 °C above present (approximately 2.7 °C above preindustrial) will confront an additional approximate 15% of the global population with a severe decrease in water resources and will increase the number of people living under absolute water scarcity (<500 m(3) per capita per year) by another 40% (according to some models, more than 100%) compared with the effect of population growth alone. For some indicators of moderate impacts, the steepest increase is seen between the present day and 2 °C, whereas indicators of very severe impacts increase unabated beyond 2 °C. At the same time, the study highlights large uncertainties associated with these estimates, with both global climate models and GHMs contributing to the spread. GHM uncertainty is particularly dominant in many regions affected by declining water resources, suggesting a high potential for improved water resource projections through hydrological model development.

Is it possible to differentiate between Takotsubo cardiomyopathy and acute anterior ST-elevation myocardial infarction?

INTRODUCTION: Several studies have investigated the ability of the twelve-lead electrocardiogram (ECG) to reliably distinguish Takotsubo cardiomyopathy (TC) from an acute anterior ST-segment elevation myocardial infarction (STEMI). In these studies, only ECG changes were required - ST-segment deviation and/or T-wave inversion - in TC whereas in acute anterior STEMI, ECGs had to meet STEMI criteria. In the majority of these studies, patients of both genders were used even though TC predominantly occurs in women. The aim of this study is to see whether TC can be distinguished from acute anterior STEMI in a predominantly female study population where all patients meet STEMI-criteria. METHODS: Retrospective analysis of the ST-segment changes was done on the triage ECGs of 37 patients with TC (34 female) and was compared to the triage ECGs of 103 female patients with acute anterior STEMI. The latter group was divided into the following subgroups: 46 patients with proximal, 47 with mid and 10 with distal LAD occlusion. Three ST-segment based ECG features were investigated: (1) Existing criterion for differentiating anterior STEMI from TC: ST-segment depression >0.5mm in lead aVR+ST-segment elevation ≤1mm in lead V1, (2) frontal plane ST-vector and (3) mean amplitude of ST-segment deviation in each lead. RESULTS: The existing ECG criterion was less accurate (76%) than in the original study (95%), with a large difference in sensitivity (26% vs. 91%). Only a frontal plane ST-vector of 60° could significantly distinguish TC from all acute anterior STEMI subgroups (p<0.01) with an overall diagnostic accuracy of 81%. The mean amplitude in inferior leads II and aVF was significantly higher for patients with TC compared to all patients with acute anterior STEMI (p<0.01 and p<0.05 respectively) and the mean amplitude in the precordial leads V1 and V2 was significantly lower compared to proximal and mid LAD occlusion (p<0.01). CONCLUSIONS: Given the consequences of missing the diagnosis of an acute anterior STEMI the diagnostic accuracy of the ECG criteria investigated in this retrospective study were insufficient to reliably distinguish patients with TC from patients with an acute anterior STEMI. To definitely exclude the diagnosis of an acute anterior STEMI coronary angiography, which remains the gold standard, will need to be performed.

Detection of factor XIII-A is a valuable tool for distinguishing dendritic cells and tissue macrophages in granuloma annulare and necrobiosis lipoidica.

BACKGROUND: Factor XIII subunit A (FXIII-A) is used as a diagnostic marker in a wide range of dermatological diseases ranging from inflammatory lesions to malignancies, although neither the cell types responsible for its expression nor the mechanism(s) resulting in its local accumulation in pathological conditions have been characterized. OBJECTIVE: In this study, we aimed to gain information on the cells showing an immunohistochemical reaction for FXIII-A and answer the question whether macrophages and/or dendritic cells are labelled for FXIII-A. METHODS: We carried out our studies on samples of granuloma annulare (GA) and necrobiosis lipoidica (NL), the prime examples for granulomatous skin lesions with a non-infectious background in which extracellular matrix remodelling is a key feature without any sign of malignant transformation. We used markers for macrophages and dendritic cells in combination with the detection of FXIII-A in double labelling immunohistochemical reactions. RESULTS: We demonstrated that FXIII-A positivity clearly distinguishes macrophages (CD163+/FXIII-A+) from dendritic cells (CD11c+/FXIII-A-) not only in the normal dermis as previously described by Zaba et al. (J Clin Invest 2007; 117: 2517-2525) but also in the pathological conditions of GA and NL. Detecting the expression of DC-SIGN/CD209 and mannose receptor molecules on FXIII-A+ macrophages we confirmed that FXIII-A is expressed in the alternatively activated macrophages. However, while DC-SIGN/CD209 was invariably expressed on FXIII-A+ cells both in normal and pathological conditions of GA/NL (98.7% vs. 93.5/96%), mannose receptor was only partially coexpressed with FXIII-A (94.8% vs. 74.7/52.2%), suggesting that FXIII-A+ macrophages do not represent a homogenous population. CONCLUSIONS: FXIII-A selectively marks macrophages and distinguishes them from dendritic cells. The presence of FXIII-A is not a disease-specific marker but indicates a possible common mechanism of macrophage activation in various dermatological diseases.

Urban growth, climate change, and freshwater availability.

Nearly 3 billion additional urban dwellers are forecasted by 2050, an unprecedented wave of urban growth. While cities struggle to provide water to these new residents, they will also face equally unprecedented hydrologic changes due to global climate change. Here we use a detailed hydrologic model, demographic projections, and climate change scenarios to estimate per-capita water availability for major cities in the developing world, where urban growth is the fastest. We estimate the amount of water physically available near cities and do not account for problems with adequate water delivery or quality. Modeled results show that currently 150 million people live in cities with perennial water shortage, defined as having less than 100 L per person per day of sustainable surface and groundwater flow within their urban extent. By 2050, demographic growth will increase this figure to almost 1 billion people. Climate change will cause water shortage for an additional 100 million urbanites. Freshwater ecosystems in river basins with large populations of urbanites with insufficient water will likely experience flows insufficient to maintain ecological process. Freshwater fish populations will likely be impacted, an issue of special importance in regions such as India's Western Ghats, where there is both rapid urbanization and high levels of fish endemism. Cities in certain regions will struggle to find enough water for the needs of their residents and will need significant investment if they are to secure adequate water supplies and safeguard functioning freshwater ecosystems for future generations.

Renewable Syngas Generation via Low-Temperature Electrolysis: Opportunities and Challenges.

The production of syngas (i.e., a mixture of CO and H2) via the electrochemical reduction of CO2 and water can contribute to the green transition of various industrial sectors. Here we provide a joint academic-industrial perspective on the key technical and economical differences of the concurrent (i.e., CO and H2 are generated in the same electrolyzer cell) and separated (i.e., CO and H2 are electrogenerated in different electrolyzers) production of syngas. Using a combination of literature analysis, experimental data, and techno-economic analysis, we demonstrate that the production of synthesis gas is notably less expensive if we operate a CO2 electrolyzer in a CO-selective mode and combine it with a separate PEM electrolyzer for H2 generation. We also conclude that by the further decrease of the cost of renewable electricity and the increase of CO2 emission taxes, such prepared renewable syngas will become cost competitive.

Symptoms of anxiety and cardiac hospitalizations at 12 months in patients with heart failure.

OBJECTIVE: Heart failure (HF) is a leading cause of hospitalization. Clinical and socio-demographic factors have been associated with cardiac admissions, but little is known about the role of anxiety. We examined whether symptoms of anxiety were associated with cardiac hospitalizations at 12 months in HF patients. METHODS: HF outpatients (N = 237) completed the Hospital Anxiety and Depression Scale (HADS) at baseline (i.e., inclusion into the study). A cutoff ≥8 was used to indicate probable clinical levels of anxiety and depression. At 12 months, a medical chart abstraction was performed to obtain information on cardiac hospitalizations. RESULTS: The prevalence of symptoms of anxiety was 24.9% (59/237), and 27.0% (64/237) of patients were admitted for cardiac reasons at least once during the 12-month follow-up period. Symptoms of anxiety were neither significantly associated with cardiac hospitalizations in univariable logistic analysis [OR = 1.13, 95% CI (0.59-2.17), p = 0.72] nor in multivariable analysis [OR = 0.94, 95% CI (0.38-2.31), p = 0.89]. New York Heart Association (NYHA) functional class III [OR = 3.00, 95% CI (1.08-8.12), p = 0.04] and a history of HF-related hospitalizations [OR = 1.18, 95% CI (1.01-1.38), p = 0.03] were independently associated with 12-month cardiac admissions. CONCLUSIONS: The current study found no significant association between symptoms of anxiety and cardiac hospitalizations at 12 months in HF patients. In contrast, clinical indicators (i.e., NYHA class III and a history of HF-related hospitalizations) were significantly associated with admissions due to a cardiac cause. Future studies are warranted to investigate the importance of symptoms of anxiety in HF using a larger sample size and a longer follow-up duration.

Type D personality and course of health status over 18 months in outpatients with heart failure: multiple mediating inflammatory biomarkers.

BACKGROUND: The distressed (Type D) personality is associated with poor health status (HS) and increased inflammatory activation in heart failure (HF). We tested whether multiple inflammatory biomarkers mediated the association between Type D personality and the course of self-reported HS over 18 months. METHODS: HF outpatients (n=228, 80% male, mean age 67.0±8.7 years), filled out the Type D questionnaire (DS14) at inclusion and the Short Form-12 (SF12) and the Kansas City Cardiomyopathy Questionnaire (KCCQ) at 0, 6, 12, and 18 months. Blood samples at inclusion were analyzed for high sensitive C-reactive protein (hsCRP), interleukin (IL)-6, tumor necrosis factor (TNF)-α, and its soluble receptors (sTNFr1, sTNFr2). A multiple mediation latent growth model was tested using structural equation modeling. RESULTS: Type D personality (prevalence=21%) was associated with poorer HS (all scales p<0.001), deterioration of mental HS (p<0.001), and higher TNF-α and sTNFr2 levels in the full mediation model. A higher inflammatory burden was associated with a poorer baseline level and a deterioration of generic physical, mental and disease-specific HS. No mediating effects were found for the multiple inflammatory biomarkers on the association between Type D and baseline self-reported HS, whereas change in physical HS was significantly mediated by the group of five inflammatory biomarkers (p=0.026). CONCLUSIONS: Only the association between Type D personality and change in self-reported physical health status was significantly mediated by inflammatory biomarkers. Future research should investigate whether the association between Type D personality and poor health status may be explained by other biological or behavioral factors.

Control or involvement? Relationship between authoritative parenting style and adolescent depressive symptomatology.

Among factors predicting adolescent mood problems, certain aspects of the parent-adolescent relationship play an important role. In previous studies, children whose parents had an authoritative style of parenting reported the best behavioral and psychological outcomes. Therefore, the main goal of this paper was to investigate the role of authoritative parenting style and other family variables (negative family interactions and positive identification with parents) in adolescents' depressive symptomatology. The study was carried out in all primary and secondary schools in Mako and the surrounding region in Hungary in the spring of 2010, students of grades 7-12 (N = 2,072): 49.2% of the sample were males; 38.1% primary school pupils; and 61.9% high school students. Self-administered questionnaires contained items of measuring depressive symptoms (CDI) and parental variables beyond sociodemographics. Beyond descriptive statistics and calculation of correlation coefficients, multiple linear regression analyses were applied to detect relationships between parental variables and depressive scores by gender. Overall, our data support a negative association between authoritative parenting style and adolescent mood problems, particularly among girls. Among boys, only mother's responsiveness was a significant predictor. Among girls, father's parenting played a decisive role; not only his responsiveness but also demandingness. Interestingly, mother's demandingness went together with an elevated depressive score for girls. Prevention programs cannot guarantee success without taking into account the role of parents. Teaching positive parenting seems to be a part of these prevention programs that may include facilitating intimate yet autonomous relationships.

Beyond Type D personality: reduced positive affect (anhedonia) predicts impaired health status in chronic heart failure.

OBJECTIVE: Type D personality has been associated with impaired health status in chronic heart failure (CHF), but other psychological factors may also be important. AIM: To determine whether non-Type D patients with low positive affect and Type D patients report lower health status, compared with non-Type D patients with high positive affect at 12-month follow-up in chronic heart failure. METHODS: Consecutive CHF outpatients (n = 276) filled out the Short Form-12 (health status) and Health Complaints Scale (disease-specific complaints) at inclusion and 12-month follow-up, and the DS14 (Type D personality) and positive affect (Global Mood Scale) at inclusion. Three groups were composed: non-Type D patients without anhedonia, non-Type D patients with anhedonia, and Type D patients. RESULTS: After controlling for demographic and clinical confounders, and scores at inclusion, anhedonic non-Type D patients reported lower mental health status (beta = -.19, P < .004), and more feelings of disability (beta = .10, P = .04), marginally lower physical health status (beta = -.11, P = .07), and equal levels of cardiac symptoms (beta = .04, P = .43), when compared with non-Type D's without anhedonia. Type D patients reported lower levels of impaired mental health status, more cardiac symptoms and feelings of disability (-.31 < beta < .17, all Ps < .05). A trend was shown for physical health status (beta = -.11, P = .09). CONCLUSION: Non-Type D patients low on positive affect and Type D patients report lower levels of health status in CHF, compared with non-Type D patients with high positive affect. Future studies need to determine whether lack of positive affect is associated with impaired clinical outcome.

Psychological predictors of prognosis in chronic heart failure.

BACKGROUND: Chronic heart failure (CHF) is an increasingly prevalent condition with high mortality and morbidity rates. This review examines the role of depression, anxiety, and social support on prognosis in CHF. METHOD AND RESULTS: Prospective studies that examined mortality as an outcome, and assessed depression, anxiety, or social support as associates were included. Methodological qualities were evaluated. In total, 25 studies were identified. Concerning depression, 6 of 15 studies of inpatients, 10 of 11 studies of outpatients, and 1 study of a mixed sample found associations between depression and prognosis, with greater associations rendered by depressive symptomatology in outpatients. Anxiety was not associated with prognosis in one inpatient study and one outpatient study. There was a univariable trend in one outpatient study for anxiety to be associated with prognosis. In two of six studies of inpatients and in two of four studies of outpatients, social support was associated with prognosis. On the basis of methodological quality, studies on depression showed mixed results, no conclusions could be drawn for anxiety because this association was not investigated soundly, and the quality of the social network was not associated with outcome. CONCLUSION: Evidence suggests that depressive symptoms and social support might be associated with prognosis in CHF outpatients, independently of biomedical risk factors. With respect to anxiety, no conclusions can be drawn. Future studies are warranted to disentangle associations with psychological factors.

Projections of historical and 21st century fluvial sediment delivery to the Ganges-Brahmaputra-Meghna, Mahanadi, and Volta deltas.

Regular sediment inputs are required for deltas to maintain their surface elevation relative to sea level, which is important for avoiding salinization, erosion, and flooding. However, fluvial sediment inputs to deltas are being threatened by changes in upstream catchments due to climate and land use change and, particularly, reservoir construction. In this research, the global hydrogeomorphic model WBMsed is used to project and contrast 'pristine' (no anthropogenic impacts) and 'recent' historical fluvial sediment delivery to the Ganges-Brahmaputra-Meghna, Mahanadi, and Volta deltas. Additionally, 12 potential future scenarios of environmental change comprising combinations of four climate and three socioeconomic pathways, combined with a single construction timeline for future reservoirs, were simulated and analysed. The simulations of the Ganges-Brahmaputra-Meghna delta showed a large decrease in sediment flux over time, regardless of future scenario, from 669 Mt/a in a 'pristine' world, through 566 Mt/a in the 'recent' past, to 79-92 Mt/a by the end of the 21st century across the scenarios (total average decline of 88%). In contrast, for the Mahanadi delta the simulated sediment delivery increased between the 'pristine' and 'recent' past from 23 Mt/a to 40 Mt/a (+77%), and then decreased to 7-25 Mt/a by the end of the 21st century. The Volta delta shows a large decrease in sediment delivery historically, from 8 to 0.3 Mt/a (96%) between the 'pristine' and 'recent' past, however over the 21st century the sediment flux changes little and is predicted to vary between 0.2 and 0.4 Mt/a dependent on scenario. For the Volta delta, catchment management short of removing or re-engineering the Volta dam would have little effect, however without careful management of the upstream catchments these deltas may be unable to maintain their current elevation relative to sea level, suggesting increasing salinization, erosion, flood hazards, and adaptation demands.

ERBB-2 (HER2/neu) gene copy number, p185HER-2 overexpression, and intratumor heterogeneity in human breast cancer.

Amplification of the ERBB-2 (HER-2/neu) gene is accompanied by overexpression of its cell surface receptor product, p185HER-2. Heterogeneity has been observed for both the gene copy number and the level of overexpression of its protein product. To better understand their relationship, correlation between the level of cellular expression of p185HER-2 and ERBB-2 gene amplification was studied in four human breast cancer cell lines (BT-474, SK-BR-3, MDA-453, and MCF-7) and in a primary human breast tumor sample. The relative expression of p185HER-2 was measured by immunofluorescence by using flow and/or image cytometry while correlated DNA analysis was performed on the same cells by fluorescence in situ hybridization to determine ERBB-2 gene and chromosome 17 copy numbers. Marked heterogeneity was observed in both protein expression and ERBB-2 copy number. Despite this heterogeneity, and in accordance with previous studies, the average levels of p185HER-2 expression correlated well with average ERBB-2 gene copy numbers in the four lines examined (r = 0.99). When the relationship between copy number and protein expression was studied on a cell-by-cell basis, p185HER-2 expression correlated with both the absolute number of ERBB-2 gene copies/cell (r = 0.59-0.63) and chromosome 17 copy number (r = 0.45-0.61). It is of interest that there was weak or no correlation between p185HER-2 protein expression and the ERBB-2 copy number:chromosome 17 copy number ratio (r = 0.0-0.25). In more than one-half of cells expressing a high level of p185HER-2, the chromosome 17 copy number was high (two or three times the average copy number), whereas < 2% of an unselected population had a high chromosome 17 copy number. Bromodeoxyuridine incorporation indicated that the S-phase-labeling index was homogeneous across various p185HER-2-expressing subpopulations in the SK-BR-3 cell line. Analysis of the primary breast tumor sample showed results similar to the cell lines, supporting the strong possibility of a mechanistic link among p185HER-2 overexpression, ERBB-2 amplification, and high chromosome 17 copy number.

Genetic alterations in primary bladder cancers and their metastases.

Bladder cancer progression is thought to be associated with sequential genetic events. To search for the specific genetic changes associated with the metastatic process, comparative genomic hybridization was performed on 22 primary tumors and 24 metastases (10 distant and 14 nodal metastases) from 17 patients with stage pT2-4 bladder cancer. There was a striking similarity between the genetic alterations present in the primary and metastatic tumor samples from the same patient. The mean number of genetic changes/tumor was 12.2 for primary tumors and 11.7 for metastases. There was a strong concordance in the specific aberrations present in each patient's primary and metastatic lesions (mean, 75%). Concordance was also high among multiple sites from an individual primary tumor (mean, 96%) and multiple metastases from the same patient (mean, 75%). There were no specific genetic changes overrepresented in the metastases compared with their primary tumors. Genetic alterations present in more than 40% of tumors included gains on 6p, 8q, 10q, and 17q and losses involving 8p, 10q, and Y. Two regions of high-level amplification were common: (a) 10q22.1-q23.1 (32.6%); and (b) 17q11-21.3 (23.9%; the locus of erbB-2). A summary statistic was developed to quantitate the degree of clonal relationships between biopsies from the same patient. These data support a model in which minimal clonal evolution occurs in the metastatic tumor cell population after the metastatic event. When comparing primary cancers from patients with and without metastases, however, several unique genetic changes were identified in those cancers with metastases, suggesting that these loci may harbor genes important to the metastatic process.

Effects of Insula Resection on Autonomic Nervous System Activity.

BACKGROUND: The insula is an essential component of the central autonomic network and plays a critical role in autonomic regulation in response to environmental stressors. The role of the insula in human autonomic regulation has been primarily investigated following cerebrovascular accidents, but interpretation of these findings is complicated by lack of control over time-related processes preceding and following cerebrovascular accidents. Surgical resection of tumors in the insula provides unique information about the neural circuits of autonomic dysregulation and subsequent cardiac arrhythmias. METHODS: This study examined autonomic modulation in 2 unique cases during tumor resection of the right and left insula, respectively (WHO grade II low-grade astrocytoma). The patients were monitored for changes in heart rate variability and cardiac arrhythmias before and during tumor resection. RESULTS: Right insular tumor resection was accompanied by significantly increased parasympathetic activity followed by bradyarrhythmias. Removal of the left insula did not change autonomic indices. CONCLUSIONS: These findings suggest that the right insula plays a critical role in parasympathetic autonomic modulation and subsequent cardiac arrhythmias. Additional research is needed to establish the long-term effects of right versus left insula resection as related to autonomic dysregulation and adverse brain-heart interactions, particularly in patients at risk of cardiac arrhythmias.

Sixteen years of change in the global terrestrial human footprint and implications for biodiversity conservation.

Human pressures on the environment are changing spatially and temporally, with profound implications for the planet's biodiversity and human economies. Here we use recently available data on infrastructure, land cover and human access into natural areas to construct a globally standardized measure of the cumulative human footprint on the terrestrial environment at 1 km(2) resolution from 1993 to 2009. We note that while the human population has increased by 23% and the world economy has grown 153%, the human footprint has increased by just 9%. Still, 75% the planet's land surface is experiencing measurable human pressures. Moreover, pressures are perversely intense, widespread and rapidly intensifying in places with high biodiversity. Encouragingly, we discover decreases in environmental pressures in the wealthiest countries and those with strong control of corruption. Clearly the human footprint on Earth is changing, yet there are still opportunities for conservation gains.